Healthcare Provider Details

I. General information

NPI: 1982103040
Provider Name (Legal Business Name): JAMES HOVERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 02/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 HOOVER RD
GROVE CITY OH
43123-9122
US

IV. Provider business mailing address

8553 APPLERIDGE CIR
PICKERINGTON OH
43147-9797
US

V. Phone/Fax

Practice location:
  • Phone: 614-471-2626
  • Fax:
Mailing address:
  • Phone: 614-864-1542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.0900526
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: